Cluster randomized controlled trial of the effectiveness of audit and feedback and educational outreach on improving nursing practice and patient outcomes.

Full Abstract

BACKGROUND:
Current understanding of implementation methods is limited, and research has focused on changing doctors' behaviors.

AIM:
Our aim was to evaluate the impact of audit and feedback and educational outreach in improving nursing practice and patient outcomes.

METHODS:
Using a factorial design, cluster randomized controlled trial, we evaluated 194 community nurses in 157 family practices and 1078 patients with diagnosis of urinary incontinence (UI) for nurses compliance with evidence-linked review criteria for the assessment and management of UI and impact on psychologic and social well-being and symptoms. In the outreach arms, nurses' self-reported barriers informed development of tailored strategies.

RESULTS:
In comparison with educational materials alone, the implementation methods tested did not improve care at 6 months follow-up. Moderate rates of improvement (10-17% of patients) in performance for the assessment of UI and greater rates of improvement (20-30% of patients) for the management of care were found but effects were similar across arms. Improvement in patient outcomes was more consistently positive for educational outreach than for audit and feedback but differences were not significant. Adjustment for caseload size, severity or duration of UI and patients' age did not alter results.

CONCLUSIONS:
Printed educational materials alone may be as effective as audit and feedback and educational outreach in improving nurses' performance and outcomes of care for people with UI. Greater understanding of the underlying processes in improving performance within multidisciplinary teams through further, theory-driven studies with "no intervention" control groups and longer follow-up are needed.

Learn Faster Today Improve your study skills

Author information

Author/s: Cheater, Francine M (FM); Baker, Richard (R); Reddish, Stuart (S); Spiers, Nicola (N); Wailoo, Allan (A); Gillies, Clare (C); Robertson, Noelle (N); Cawood, Catherine (C);

Affiliation: School of Healthcare, University of Leeds, Leeds, and Leicestershire & Rutland Healthcare NHS Trust, Gorse Hill Hospital, Leicester, United Kingdom. f.m.cheater(-atsign-)leeds.ac.uk

Journal and publication information

Publication Type: Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't

Journal: Medical care (Med Care), published in United States. (Language: eng)

Reference: 2006-Jun; vol 44 (issue 6) : pp 542-51

Dates: Created 2006/05/18; Completed 2006/06/27; Revised 2007/01/26;

PMID: 16708003, status: MEDLINE (last retrieval date: 12/26/2008)

Sourced from the National Library of Medicine. Abstract text and other information may be subject to copyright.

Comments and Corrections

CommentIn: Evid Based Nurs. 2007 Jan;10(1):26. (PMID: 17218300)

External Links for this article (including full text providers, if available):

Click Electronic Full-text Provider Links to see options for finding the electronic full text links to this article. Note there may be a subscription or fee required for access to the full text. See our FAQ for information on finding FREE full text articles.

This article may also be located in paper journal collections available in many libraries. Use the Journal and Publication Information above to find the full article.

MeSH headings (categories)

This article was linked to the MESH Headings shown below.

Nursing Care - organization & administration
Outcome Assessment (Health Care) - organization & administration
Program Evaluation
Quality of Health Care - organization & administration
Urinary Incontinence - nursing
Workload

These are the highest related articles currently in the database:

See 100+ related articles.